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Home My WebLink About2672-zFOR~ NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No...2[..22~ ........... Date ......................... All~ll,~t....3O ...... , 19.65- THIS CERTIFIES that the building located at .~/~....~O~.r~o~...~b~t .............................. Street Map No .~.e~o~i,o...~B~ckOaJ~ ..................... Lot No..p.~..-'lot..2,t ..... ~.ecQTL~O~...[~.~'~ .......... conforms substanhally to the Application for Budding Permit heretofore filed in this office dated .................................. M~.e~ ....... .1.~ ........ , 19..(~.~. pursuant to which Building Permit No. dated .......................~,Z~ ....... ~ ........ , 19...6.~, was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which thru certificate is issued is ........ ....... P.~i~ ate...one.. ~-.mil~... dwel _1 !n~ ................................................................................... The certificate is issued to ........ ~e~..~..~r..~aj[~II.~.~;~ ........................ 01~e~. ............................... (owner, lessee or tenant) of the aforesaid building. H.D. Approval August 27, 196~ · 'O]~lVi NO. 2: TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 2672 Z Permission is hereby granted to: (i, eorg. e.....AI~:Le~I.....A/.~:..lte~'.,......r~a~;r,~'.. to ~..~ll~..~e~.. ~..f~l~..~ ~ ............................................................................... at premises located at .... ~.-~..(m~e-.eea.~[e~.) ..... ~eeon~e..~..oa~e ...................... ........................................... ~..~o~a~..~aae. ............... gee~ ....................................... pursuant to application dated ............................... ~.Ch....~. ........ 19..~'., and approved by the Building Ir~spector Fee $..~).,..~. ......... Building Inspecto~ SUFFOLK CO~2Y D~,K~ OF HEkLTH Building Permit TO ~,fHCM IT FAY CONCEP~: dsewage disposal facilities for a structure l~.~ted at .... 'ee~ 'l ' · ' - have been inspected by this Departnent and found to be satisfactory. District Engineer TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved t( 19 ........ ~ Permit No~:~ ~' ? ~ ~ (Building Inspector) INSTRUCTIONS (3. This apphcatlon must be completely filled in by typewriter or in ink and submitted in duplicate to the BuJldinc Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets o, areas, and g~ving a detailed description of layout of propertymust be drawn on the diagram which is part of this application c. The work covered by this application may not be commenced before issuance of Building Permit. d Upon approval of this application, the Building Inspector w~ll issue a Building Permit to the applicant. Suck permit shall be kept on the premises available for inspection throughout the progress of the work. e No building shall be occupied or used in whole or m part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The apphcant agrees to comply with al~ applicable laws, ordinances, building code and regul?ti~ns. ......... ......... .................... ............ Name of owner of premises ..............~.....~.... ..............--~...~ ...... ...~.....~ ........................................................ If applicant ~s o corporate, signature of duly authorized officer. 1 Location of land on which~ork will be done. Map No-: ........................................... Lot No: ....~ .......... Street and Number Municipality 2. State existing use and occupancy of premises (:nd intended use and occupancy of proposed construction: a. Ex~sting use and occupancy ................................................................................................................................... b. Intended use and occupancy ............................... ...~..~ 3. Nature of work (check which apphcable): New Building ...... /~ ......... Addition .................. Alteration ................ Repair .................... Removal .................... Demohtion ................... Other Work (Describe) ..................................... 4. Esbmated Cost ............../..~.¢.Z.0...O. ................................ Fee ......................................................................................... (to be paid on filing th~s apphcation) .5. If dwelhng, number of dwelling umts ......... ~5. ................ Number of dwelling umts on each floor .................. ~/ .... If garage, number of cars .......................................................................................................................................... 6. If business, commercial or m~xed occupancy, specify nature and extent of each type of use ............................... 7. Dimensions of ex~stmg structures, if any: Front ..........................Rear .......................... Depth ........................... Height ............................ Number of Stones .............................................................................................................. D~mens~ons of same structure with alterations or additions Front ................................ Rear ............................... Depth .............................. Height .............................. Number of Stones ........................................ 8. D~mens~ons of enbre new construction Front ........... .~..O.~... ......... Rear ......... ..~..~.. ........... Depth .....~..?. ................ Height ................ .~..O. ....... Number of Stories ...... ./..~ ................ 9. S~ze of lot Front ............................ Rear ............................ Depth ................................ 10 Date of Purchase ........................................................ Name of Former Owner ....................................................... 11. Zone or use d~stnct in which premises are s~tuated 12. Does proposed construction wolate any zomng law, ordinance or regulation? ..................................................... /~,.~AA Address ~'-'~ ..~ I~/~ .~..~ Name of Owner of prem,ses ............... ......r.~!....._ ...... ..Z2.........~.~..(...../~,. ~._~../fRf,f.. Phone ....... 13. Name of Architect ...................................................... Address ............................................ Phone No .................... Name of Contractor ........... £& ............................ Address ..~--.0..~.%..~..¢.:..:.:.~....n.¥.:.¥:.;.:. Phone No. PLOT DIAGRAM Locate clearly and distinctly all buddings, whether ex~sting or proposed, and indicate all set-back dimensions fron property hnes G~ve street and block numbers or description according to deed, and show street names and ind~cat, whether ~nterior or corner lot. STATE OF NEW 2¢OI}1~ , / S S. COUNTY OF ~r'-ca.('...q..~. zl~.~l~/e~:~ .......................................... being duly sworn, deposes and says that he is the applicanl ......... ................................................................................ (Contractor, agent, corporate officer, etc.) of sam owner or owners, end is duly authorized to perform or have performed the said work and to make and th~s apphcation; that all statements contained in this apphcation are true to the best of his knowledge and belief. and that the work wdl be performed in the manner set forth m the opplicabon f, led therewith. Sworn to befor~n, e this Notary Pub h c~... ~~Cou r~ f.' '~;~;'~-~ ' '~"~i~'¢e";~ ?";~;~;ii;'~'~;r')' ............................ .... ~ ¢~rc~ 30,